PSYC 350 MIDTERM EXAM QUESTIONS WITH
ANSWERS AND EXPLANATIONS
| American Public University
1. When reviewing the following case, which conclusion is the most defensible based on the information
provided? A symptom scale produces nearly the same score when repeated a few days later before treatment
begins.
A. The pattern most strongly supports interrater reliability.
B. The pattern most strongly supports test-retest reliability.
C. The pattern most strongly supports mental status examination.
D. The pattern most strongly supports self-report measure.
Correct Answer: B. The pattern most strongly supports test-retest reliability.
Explanation: Test-retest reliability is the best conclusion because the presentation matches the stability of a
measurement when the same construct is assessed again under comparable conditions. A full real-world
assessment would still evaluate medical, substance-related, developmental, and cultural alternatives where
relevant.
2. Which concept is best defined as trauma-related symptoms such as exaggerated startle, hypervigilance,
sleep disturbance, irritability, or concentration problems?
A. post-traumatic stress disorder
B. cognitive processing therapy
C. intrusion symptoms
D. hyperarousal and reactivity
Correct Answer: D. hyperarousal and reactivity
Explanation: Hyperarousal and reactivity refers to trauma-related symptoms such as exaggerated startle,
hypervigilance, sleep disturbance, irritability, or concentration problems. The alternatives name different
constructs within the same clinical area.
3. When reviewing the following case, which conclusion is the most defensible based on the information
provided? A client with a dog phobia gradually approaches calm dogs with therapist support instead of
escaping from the feared situation.
A. The pattern most strongly supports exposure therapy.
B. The pattern most strongly supports safety behavior.
C. The pattern most strongly supports agoraphobia.
D. The pattern most strongly supports panic attack.
Correct Answer: A. The pattern most strongly supports exposure therapy.
Explanation: Exposure therapy is the best conclusion because the presentation matches a treatment approach
involving systematic contact with feared cues while reducing avoidance so new learning can occur. A full
real-world assessment would still evaluate medical, substance-related, developmental, and cultural alternatives
where relevant.
,4. Which diagnosis or concept best fits this presentation? An adult has brief episodes of destructive rage after
minor frustrations and later reports the aggression was not planned.
A. oppositional defiant disorder
B. proactive aggression
C. multisystemic intervention
D. intermittent explosive disorder
Correct Answer: D. intermittent explosive disorder
Explanation: The defining pattern is most consistent with intermittent explosive disorder: recurrent impulsive
aggressive outbursts that are grossly out of proportion to provocation and are not premeditated for gain. The
distractors share some surface features but do not match the central pattern.
5. Which diagnosis or concept best fits this presentation? Daily rituals consume several hours, interfere with
work, and are driven by intrusive doubts the person finds distressing.
A. obsessive-compulsive disorder
B. obsession
C. poor insight in OCD
D. body dysmorphic disorder
Correct Answer: A. obsessive-compulsive disorder
Explanation: The defining pattern is most consistent with obsessive-compulsive disorder: a condition involving
obsessions, compulsions, or both that are time-consuming or cause substantial distress or impairment. The
distractors share some surface features but do not match the central pattern.
6. Which concept is best defined as a clinically significant disturbance involving dysfunction plus distress or
impairment rather than mere unusualness?
A. cultural context
B. harmful dysfunction
C. deinstitutionalization
D. medical model
Correct Answer: B. harmful dysfunction
Explanation: Harmful dysfunction refers to a clinically significant disturbance involving dysfunction plus distress
or impairment rather than mere unusualness. The alternatives name different constructs within the same clinical
area.
7. Which underlying principle or clinical feature best accounts for the key finding in this case? A therapist
asks a client who feels unreal to name visible objects, notice feet on the floor, and describe current sounds
and textures.
A. grounding technique
B. dissociative amnesia
C. state-dependent memory
D. depersonalization
Correct Answer: A. grounding technique
Explanation: The key feature points to grounding technique, meaning a strategy that directs attention to
immediate sensory information and the present environment to reduce dissociative detachment. This identifies the
primary mechanism or syndrome rather than a less specific accompanying feature.
,8. Which concept is best defined as potentially dangerous metabolic and electrolyte shifts that can occur
when nutrition is restored too rapidly after severe malnutrition?
A. rumination disorder
B. binge-eating disorder
C. refeeding syndrome risk
D. anorexia nervosa
Correct Answer: C. refeeding syndrome risk
Explanation: Refeeding syndrome risk refers to potentially dangerous metabolic and electrolyte shifts that can
occur when nutrition is restored too rapidly after severe malnutrition. The alternatives name different constructs
within the same clinical area.
9. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies the
following case? A clinician asks specifically whether a depressed client has thoughts of suicide, a plan,
access to lethal means, past attempts, and reasons for living.
A. major depressive episode - a period of at least two weeks with depressed mood or loss of interest plus
additional cognitive, behavioral, or physical symptoms causing impairment
B. suicidal ideation assessment - direct evaluation of thoughts about death or self-harm together with intent,
plan, means, history, and protective factors
C. persistent depressive disorder - a chronic depressive condition characterized by depressed mood for most of
the day on more days than not over a prolonged period
D. hopelessness - a pervasive expectation that negative outcomes will continue and desired outcomes will not
occur
Correct Answer: B. suicidal ideation assessment - direct evaluation of thoughts about death or self-harm
together with intent, plan, means, history, and protective factors
Explanation: The case is best classified as suicidal ideation assessment because its central feature is direct
evaluation of thoughts about death or self-harm together with intent, plan, means, history, and protective factors.
The other options describe distinct clinical patterns.
10. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies
the following case? A child repeatedly engages in hand biting and body rocking to the point of tissue injury.
Focus on the feature that most clearly distinguishes the alternatives.
A. stereotypic movement disorder - repetitive, seemingly driven motor behavior that interferes with activities or
causes injury and is not better explained by another condition
B. early developmental onset - the principle that neurodevelopmental disorders emerge during the
developmental period even if demands later make impairment more obvious
C. executive-function difficulty in ADHD - problems with planning, inhibition, working memory, and
sustained goal-directed organization often associated with ADHD
D. multimodal intervention for ADHD - use of coordinated behavioral, educational, family, and when
appropriate medication strategies to address impairment
Correct Answer: A. stereotypic movement disorder - repetitive, seemingly driven motor behavior that
interferes with activities or causes injury and is not better explained by another condition
Explanation: The case is best classified as stereotypic movement disorder because its central feature is repetitive,
seemingly driven motor behavior that interferes with activities or causes injury and is not better explained by
another condition. The other options describe distinct clinical patterns.
, 11. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies
the following case? A person secretly contaminates laboratory samples to appear ill even though no
financial, legal, or occupational gain is evident.
A. illness anxiety disorder - persistent preoccupation with having or acquiring a serious illness despite minimal
or absent somatic symptoms and repeated reassurance
B. factitious disorder - intentional falsification or induction of symptoms in the absence of obvious external
rewards, associated with adopting the sick role
C. iatrogenic reinforcement - unintended strengthening of illness behavior through repeated tests, attention, or
responses from health systems
D. malingering - intentional production or exaggeration of symptoms motivated by clear external incentives
rather than a mental disorder diagnosis
Correct Answer: B. factitious disorder - intentional falsification or induction of symptoms in the absence of
obvious external rewards, associated with adopting the sick role
Explanation: The case is best classified as factitious disorder because its central feature is intentional falsification
or induction of symptoms in the absence of obvious external rewards, associated with adopting the sick role. The
other options describe distinct clinical patterns.
12. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies
the following case? After a frightening dog bite, a child becomes intensely afraid whenever a similar dog
appears.
A. cognitive vulnerability - habitual beliefs or information-processing patterns that increase susceptibility to
psychological symptoms
B. classical conditioning - learning in which a previously neutral cue acquires fear or another response after
association with an aversive event
C. epigenetic regulation - environmentally influenced changes in gene expression that do not require changing
the DNA sequence itself
D. gene-environment interaction - a pattern in which the effects of genetic differences depend on environmental
conditions or the effects of environments depend on genotype
Correct Answer: B. classical conditioning - learning in which a previously neutral cue acquires fear or another
response after association with an aversive event
Explanation: The case is best classified as classical conditioning because its central feature is learning in which a
previously neutral cue acquires fear or another response after association with an aversive event. The other options
describe distinct clinical patterns.
13. Which concept is best defined as a treatment integrating acceptance and change strategies with skills in
mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness?
A. informed consent
B. stepped care
C. dialectical behavior therapy
D. evidence-based practice
Correct Answer: C. dialectical behavior therapy
Explanation: Dialectical behavior therapy refers to a treatment integrating acceptance and change strategies with
skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The alternatives name
different constructs within the same clinical area.
ANSWERS AND EXPLANATIONS
| American Public University
1. When reviewing the following case, which conclusion is the most defensible based on the information
provided? A symptom scale produces nearly the same score when repeated a few days later before treatment
begins.
A. The pattern most strongly supports interrater reliability.
B. The pattern most strongly supports test-retest reliability.
C. The pattern most strongly supports mental status examination.
D. The pattern most strongly supports self-report measure.
Correct Answer: B. The pattern most strongly supports test-retest reliability.
Explanation: Test-retest reliability is the best conclusion because the presentation matches the stability of a
measurement when the same construct is assessed again under comparable conditions. A full real-world
assessment would still evaluate medical, substance-related, developmental, and cultural alternatives where
relevant.
2. Which concept is best defined as trauma-related symptoms such as exaggerated startle, hypervigilance,
sleep disturbance, irritability, or concentration problems?
A. post-traumatic stress disorder
B. cognitive processing therapy
C. intrusion symptoms
D. hyperarousal and reactivity
Correct Answer: D. hyperarousal and reactivity
Explanation: Hyperarousal and reactivity refers to trauma-related symptoms such as exaggerated startle,
hypervigilance, sleep disturbance, irritability, or concentration problems. The alternatives name different
constructs within the same clinical area.
3. When reviewing the following case, which conclusion is the most defensible based on the information
provided? A client with a dog phobia gradually approaches calm dogs with therapist support instead of
escaping from the feared situation.
A. The pattern most strongly supports exposure therapy.
B. The pattern most strongly supports safety behavior.
C. The pattern most strongly supports agoraphobia.
D. The pattern most strongly supports panic attack.
Correct Answer: A. The pattern most strongly supports exposure therapy.
Explanation: Exposure therapy is the best conclusion because the presentation matches a treatment approach
involving systematic contact with feared cues while reducing avoidance so new learning can occur. A full
real-world assessment would still evaluate medical, substance-related, developmental, and cultural alternatives
where relevant.
,4. Which diagnosis or concept best fits this presentation? An adult has brief episodes of destructive rage after
minor frustrations and later reports the aggression was not planned.
A. oppositional defiant disorder
B. proactive aggression
C. multisystemic intervention
D. intermittent explosive disorder
Correct Answer: D. intermittent explosive disorder
Explanation: The defining pattern is most consistent with intermittent explosive disorder: recurrent impulsive
aggressive outbursts that are grossly out of proportion to provocation and are not premeditated for gain. The
distractors share some surface features but do not match the central pattern.
5. Which diagnosis or concept best fits this presentation? Daily rituals consume several hours, interfere with
work, and are driven by intrusive doubts the person finds distressing.
A. obsessive-compulsive disorder
B. obsession
C. poor insight in OCD
D. body dysmorphic disorder
Correct Answer: A. obsessive-compulsive disorder
Explanation: The defining pattern is most consistent with obsessive-compulsive disorder: a condition involving
obsessions, compulsions, or both that are time-consuming or cause substantial distress or impairment. The
distractors share some surface features but do not match the central pattern.
6. Which concept is best defined as a clinically significant disturbance involving dysfunction plus distress or
impairment rather than mere unusualness?
A. cultural context
B. harmful dysfunction
C. deinstitutionalization
D. medical model
Correct Answer: B. harmful dysfunction
Explanation: Harmful dysfunction refers to a clinically significant disturbance involving dysfunction plus distress
or impairment rather than mere unusualness. The alternatives name different constructs within the same clinical
area.
7. Which underlying principle or clinical feature best accounts for the key finding in this case? A therapist
asks a client who feels unreal to name visible objects, notice feet on the floor, and describe current sounds
and textures.
A. grounding technique
B. dissociative amnesia
C. state-dependent memory
D. depersonalization
Correct Answer: A. grounding technique
Explanation: The key feature points to grounding technique, meaning a strategy that directs attention to
immediate sensory information and the present environment to reduce dissociative detachment. This identifies the
primary mechanism or syndrome rather than a less specific accompanying feature.
,8. Which concept is best defined as potentially dangerous metabolic and electrolyte shifts that can occur
when nutrition is restored too rapidly after severe malnutrition?
A. rumination disorder
B. binge-eating disorder
C. refeeding syndrome risk
D. anorexia nervosa
Correct Answer: C. refeeding syndrome risk
Explanation: Refeeding syndrome risk refers to potentially dangerous metabolic and electrolyte shifts that can
occur when nutrition is restored too rapidly after severe malnutrition. The alternatives name different constructs
within the same clinical area.
9. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies the
following case? A clinician asks specifically whether a depressed client has thoughts of suicide, a plan,
access to lethal means, past attempts, and reasons for living.
A. major depressive episode - a period of at least two weeks with depressed mood or loss of interest plus
additional cognitive, behavioral, or physical symptoms causing impairment
B. suicidal ideation assessment - direct evaluation of thoughts about death or self-harm together with intent,
plan, means, history, and protective factors
C. persistent depressive disorder - a chronic depressive condition characterized by depressed mood for most of
the day on more days than not over a prolonged period
D. hopelessness - a pervasive expectation that negative outcomes will continue and desired outcomes will not
occur
Correct Answer: B. suicidal ideation assessment - direct evaluation of thoughts about death or self-harm
together with intent, plan, means, history, and protective factors
Explanation: The case is best classified as suicidal ideation assessment because its central feature is direct
evaluation of thoughts about death or self-harm together with intent, plan, means, history, and protective factors.
The other options describe distinct clinical patterns.
10. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies
the following case? A child repeatedly engages in hand biting and body rocking to the point of tissue injury.
Focus on the feature that most clearly distinguishes the alternatives.
A. stereotypic movement disorder - repetitive, seemingly driven motor behavior that interferes with activities or
causes injury and is not better explained by another condition
B. early developmental onset - the principle that neurodevelopmental disorders emerge during the
developmental period even if demands later make impairment more obvious
C. executive-function difficulty in ADHD - problems with planning, inhibition, working memory, and
sustained goal-directed organization often associated with ADHD
D. multimodal intervention for ADHD - use of coordinated behavioral, educational, family, and when
appropriate medication strategies to address impairment
Correct Answer: A. stereotypic movement disorder - repetitive, seemingly driven motor behavior that
interferes with activities or causes injury and is not better explained by another condition
Explanation: The case is best classified as stereotypic movement disorder because its central feature is repetitive,
seemingly driven motor behavior that interferes with activities or causes injury and is not better explained by
another condition. The other options describe distinct clinical patterns.
, 11. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies
the following case? A person secretly contaminates laboratory samples to appear ill even though no
financial, legal, or occupational gain is evident.
A. illness anxiety disorder - persistent preoccupation with having or acquiring a serious illness despite minimal
or absent somatic symptoms and repeated reassurance
B. factitious disorder - intentional falsification or induction of symptoms in the absence of obvious external
rewards, associated with adopting the sick role
C. iatrogenic reinforcement - unintended strengthening of illness behavior through repeated tests, attention, or
responses from health systems
D. malingering - intentional production or exaggeration of symptoms motivated by clear external incentives
rather than a mental disorder diagnosis
Correct Answer: B. factitious disorder - intentional falsification or induction of symptoms in the absence of
obvious external rewards, associated with adopting the sick role
Explanation: The case is best classified as factitious disorder because its central feature is intentional falsification
or induction of symptoms in the absence of obvious external rewards, associated with adopting the sick role. The
other options describe distinct clinical patterns.
12. A clinician is differentiating several related possibilities. Which interpretation most precisely classifies
the following case? After a frightening dog bite, a child becomes intensely afraid whenever a similar dog
appears.
A. cognitive vulnerability - habitual beliefs or information-processing patterns that increase susceptibility to
psychological symptoms
B. classical conditioning - learning in which a previously neutral cue acquires fear or another response after
association with an aversive event
C. epigenetic regulation - environmentally influenced changes in gene expression that do not require changing
the DNA sequence itself
D. gene-environment interaction - a pattern in which the effects of genetic differences depend on environmental
conditions or the effects of environments depend on genotype
Correct Answer: B. classical conditioning - learning in which a previously neutral cue acquires fear or another
response after association with an aversive event
Explanation: The case is best classified as classical conditioning because its central feature is learning in which a
previously neutral cue acquires fear or another response after association with an aversive event. The other options
describe distinct clinical patterns.
13. Which concept is best defined as a treatment integrating acceptance and change strategies with skills in
mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness?
A. informed consent
B. stepped care
C. dialectical behavior therapy
D. evidence-based practice
Correct Answer: C. dialectical behavior therapy
Explanation: Dialectical behavior therapy refers to a treatment integrating acceptance and change strategies with
skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The alternatives name
different constructs within the same clinical area.
